Transcutaneous ultrasound measurement of blood-flow in internal mammary artery to coronary artery grafts

• Published in: The Lancet (British edition) Vol. 339; no. 8790; pp. 379 - 381
• Main Authors: de Bono, D.P., Samani, N.J., Spyt, T.J., Hartshorne, T., Thrush, A.J., Evans, D.H.
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 15.02.1992; Lancet; Elsevier Limited
• Subjects: Biological and medical sciences; Blood; Blood Flow Velocity; Cardiovascular system; Circulatory system; Coronary Circulation; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Female; Humans; Internal Mammary-Coronary Artery Anastomosis; Investigative techniques, diagnostic techniques (general aspects); Male; Mammary Arteries - diagnostic imaging; Mammary Arteries - physiopathology; Medical imaging; Medical research; Medical sciences; Methods; Ultrasonic investigative techniques; Ultrasonography; Sonography; Human; Echography; Exploration; Internal mammary artery; Technique; Blood flow; Percutaneous route
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/0140-6736(92)90076-F

Transcutaneous doppler ultrasound was used to examine internal-mammary-artery (IMA) blood-flow in 26 patients with I MA coronary bypass grafts. The ungrafted right IMA could be seen in all of 19 patients, the grafted left IMA in 16 of 26, and the grafted right IMA in 3 of 7. The velocity profile recorded from the proximal part of the grafted IMA is distinct from that of an ungrafted artery, with a systolic peak which reflects graft capacitance in the face of high intramyocardial resistance, and a diastolic peak which represents graft conductance when intramyocardial resistance is low. Total graft blood-flow can be estimated from the mean velocity and the measured vessel diameter; resting flows ranged from 22 to 79 ml/min. In recently grafted patients, resting graft blood-flow correlated with myocardial "run-off" estimated from preoperative arteriograms; graft blood-flow increased appropriately with exercise. This simple, non-invasive technique to measure IMA graft blood-flow may find applications for routine postoperative follow-up of patients with IMA grafts and for studies on the physiology and pharmacology of coronary artery blood-flow.